Individual
CANY TAN CHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3330 N CENTRE LAKE DR., ONTARIO, CA 91761
(925) 466-0357
Mailing address
3330 N CENTRE LAKE DR., ONTARIO, CA 91761
(925) 466-0357
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
96233
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7184
MEDICAL
CA
01
—
7368
MEDICAL
CA
01
—
7667
MEDICAL
CA
01
—
7708
MEDICAL
CA
Enumeration date
01/18/2011
Last updated
12/22/2021
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